Objective:To evaluate the safety,efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy(mini-PCNL).Methods:A retrospective study was conducted including 200 patients who underwent m...Objective:To evaluate the safety,efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy(mini-PCNL).Methods:A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones.All patients underwent PCNL using Electro-Medical Systems laser.In addition to the laser in 100 patients,a suction device was used(laser with suction[LWS]).In the other 100,suction device was not used(laser with no additional suction[LOS]).Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was used.Primary end point was stone clearance.Results:Both the groups were comparable in terms of demographic data.Mean stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS,respectively.Mean Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS,respectively.Operative time was less in LWS group(56.89±19.65 min)as compared to LOS(62.01±28.81 min).At one-month follow-up,radiological complete clearance was 96%in LWS and 92%in LOS.On subgroup analysis of stones larger than 18 mm,the clearance rate was in favour of LWS(85.7%vs.100%)and also the need for nephrostomy placement was less in LWS group.Conclusions:LWS device is safe and efficacious when used with mini-PCNL.For stones greater than 18 mm,it has a better stone free rate as compared to using no suction.展开更多
Objective: To compare the trauma between combined retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for upper ureteral calculi. Methods: Patients with upper ureteral calculi who received lithotripsy ...Objective: To compare the trauma between combined retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for upper ureteral calculi. Methods: Patients with upper ureteral calculi who received lithotripsy in Pengzhou Hospital of Traditional Chinese Medicine between February 2015 and March 2017 were selected and randomly divided into two groups;RIRS group received combined retrograde intrarenal surgery and the Mini-PCNL group received mini-percutaneous nephrolithotomy. 3 d after surgery;the contents of liver and kidney function indexes and stress hormones in serum as well as the expression of CD4+T cell transcription factors in peripheral blood were measured. Results: Serum ALT;AST;γ-GT;BUN and Cr contents of RIRS group 3 d after surgery were not significantly different from those of Mini-PCNL group;and HO-1;ET-1;ACTH;Cor and YKL-40 contents in serum as well as RORγt and T-bet mRNA expression in peripheral blood were significantly lower than those of Mini-PCNL group while Gata-3 and Foxp3 mRNA expression in peripheral blood were higher than those of Mini-PCNL group. Conclusion: Combined retrograde intrarenal surgery for upper ureteral calculi activates less stress response and inflammatory response than mini-percutaneous nephrolithotomy.展开更多
Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a ...Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a narrative review of relevant English-language articles up to October 2022 using the PubMed and Web of Science databases.The following keywords were used in the search:“percutaneous nephrolithotomy”,“minimally invasive percutaneous nephrolithotomy”,“mini-PCNL”,“mini-perc”,“mPCNL”,and“miniaturization”.Results:A series of new progress has been made in many aspects of mini-PCNL,such as further reduction of tract sizedneedle perc and further improvement of robotic-assisted PCNLdartificial intelligence-powered robotic devices.Conclusion:Many studies and trials have been conducted to reduce morbidity and increase the safety and effectiveness of mini-PCNL.It is crucial to realize that miniaturization of PCNL requires not only a smaller percutaneous tract size,but also an adjustment strategically in renal access,stone removal,lithotripsy,and surgical model in general.More large-scale prospective research needs to be carried out to further validate and optimize the safety and effectiveness of mini-PCNL.展开更多
文摘Objective:To evaluate the safety,efficacy and feasibility of laser with suction device in mini-percutaneous nephrolithotomy(mini-PCNL).Methods:A retrospective study was conducted including 200 patients who underwent mini-PCNL for renal stones.All patients underwent PCNL using Electro-Medical Systems laser.In addition to the laser in 100 patients,a suction device was used(laser with suction[LWS]).In the other 100,suction device was not used(laser with no additional suction[LOS]).Mini-PCNL was performed using standard technique and Karl Storz minimally invasive PCNL-medium system was used.Primary end point was stone clearance.Results:Both the groups were comparable in terms of demographic data.Mean stone size was 15.24±5.90 mm and 16.16±5.53 mm in LWS and LOS,respectively.Mean Hounsfield unit of stone was 1285.64 and 1206.79 in LWS and LOS,respectively.Operative time was less in LWS group(56.89±19.65 min)as compared to LOS(62.01±28.81 min).At one-month follow-up,radiological complete clearance was 96%in LWS and 92%in LOS.On subgroup analysis of stones larger than 18 mm,the clearance rate was in favour of LWS(85.7%vs.100%)and also the need for nephrostomy placement was less in LWS group.Conclusions:LWS device is safe and efficacious when used with mini-PCNL.For stones greater than 18 mm,it has a better stone free rate as compared to using no suction.
文摘Objective: To compare the trauma between combined retrograde intrarenal surgery and mini-percutaneous nephrolithotomy for upper ureteral calculi. Methods: Patients with upper ureteral calculi who received lithotripsy in Pengzhou Hospital of Traditional Chinese Medicine between February 2015 and March 2017 were selected and randomly divided into two groups;RIRS group received combined retrograde intrarenal surgery and the Mini-PCNL group received mini-percutaneous nephrolithotomy. 3 d after surgery;the contents of liver and kidney function indexes and stress hormones in serum as well as the expression of CD4+T cell transcription factors in peripheral blood were measured. Results: Serum ALT;AST;γ-GT;BUN and Cr contents of RIRS group 3 d after surgery were not significantly different from those of Mini-PCNL group;and HO-1;ET-1;ACTH;Cor and YKL-40 contents in serum as well as RORγt and T-bet mRNA expression in peripheral blood were significantly lower than those of Mini-PCNL group while Gata-3 and Foxp3 mRNA expression in peripheral blood were higher than those of Mini-PCNL group. Conclusion: Combined retrograde intrarenal surgery for upper ureteral calculi activates less stress response and inflammatory response than mini-percutaneous nephrolithotomy.
文摘Objective:To summarize recent advancements in mini-percutaneous nephrolithotomy(mini-PCNL)in surgical technique,stone removal strategy,lithotripsy,and surgical model from the current literature.Methods:We conducted a narrative review of relevant English-language articles up to October 2022 using the PubMed and Web of Science databases.The following keywords were used in the search:“percutaneous nephrolithotomy”,“minimally invasive percutaneous nephrolithotomy”,“mini-PCNL”,“mini-perc”,“mPCNL”,and“miniaturization”.Results:A series of new progress has been made in many aspects of mini-PCNL,such as further reduction of tract sizedneedle perc and further improvement of robotic-assisted PCNLdartificial intelligence-powered robotic devices.Conclusion:Many studies and trials have been conducted to reduce morbidity and increase the safety and effectiveness of mini-PCNL.It is crucial to realize that miniaturization of PCNL requires not only a smaller percutaneous tract size,but also an adjustment strategically in renal access,stone removal,lithotripsy,and surgical model in general.More large-scale prospective research needs to be carried out to further validate and optimize the safety and effectiveness of mini-PCNL.
